We all like to believe that we are good employees in whatever type of nursing job we have. But in my 35 years of experience, I have seen many nurses suffer through the presentation of write ups. These indicate that they have done something less than acceptable in the workplace.
These types of disciplinary encounters hit at the core of our egos. In many situations, the first response is one of denial or defensiveness caused by our inability to take a hit to the ego. It goes against the core belief of, “I am a good nurse, how could this be?”
The reality is that there are times when we are not at our best. We make mistakes or have periods in our lives where illness or personal pressures cause stress at work. The key to surviving these hard times and protecting your job in the long run depends largely on your behaviors and strategies when presented with a disciplinary action.
The Right Reaction
The first appropriate response to this type of encounter should be one of emotional intelligence rather than defensiveness. Just listen to the scenario and don’t react initially. Take yourself out of the situation and remain objective and analytical.
It’s easier said than done. But in my experience, a staff member that accepts constructive criticism has a better chance of soliciting support from management and the help to improve.
There seem to be four general categories of write ups that repeat themselves in the workplace. They include attendance and tardiness, inappropriate behavior in the workplace, substance abuse or theft and mistakes made at the point of care. I will discuss all of these separately, as leader responses will vary depending on the type of incidence.
Good attendance is an expectation in all organizations. When you accept a nursing job, by virtue of your contract with the organization, you agree to work when assigned. You should be ready to work in the appropriate area at the appropriate time.
One of my greatest mentors taught me that “to be on time is to be late.” I live by that rule. This is one of the most objective measures of performance because if you are not there, you cannot perform your job. This is regardless of how you feel about yourself in regards to patient care. When confronted with this type of write up, if all the data is true, you need to be accepting of the discipline. You must work with your manager to focus on strategies for you to improve in this area.
This can be defined as the display of poor attitude, or a confrontational and intimidating behavior in the workplace. It can be also based on complaints from patients. These offenses are more subjective than attendance and are usually observed by nursing managers, coworkers, patients or visitors. Usually, the staff member does not recognize that their behavior is a problem. These behaviors are also repetitive in nature and destroy the work environment. These can create a dangerous situation for both staff and patients.
If you are written up for this type of behavior, your first response should be a reflective look at your behavior and a sincere willingness to change. Most organizations have classes that you can attend and other resources to help you if you ask. With the focus on patient service, this type of behavior is not tolerated, nor should it be. Our work as nurses should be focused on our patients and not our own need for drama.
Theft and Substance Abuse
If there is documented proof that you have stolen from the organization, you will lose your job. There will be little you can do. However, many organizations will give you the opportunity to resign rather than be terminated. It is best for you to admit it and move on. I have actually had staff members who were accused of stealing, with video images showing proof of the theft, and still they denied it. Do not add a lie and make a bad situation worse.
Substance abuse in nursing, however, is a delicate subject. If you are a victim of substance abuse, your best strategy is to approach your manager and ask for help. Most organizations have processes and resources to help staff through these tough times.
Mistakes at the Point of Care
Studies are beginning to suggest that mistakes are not necessarily the fault of the individual. Rather, it is a flaw in the process which eventually breaks down and causes injury to the patient.
Additional pressures and underfunding of hospitals can also place staff and patients in perilous situations. This is due to reductions in personnel and other resources. In response to this knowledge, many hospitals and healthcare organizations are utilizing a non-punitive approach to mistakes and accidents at the point of care.
That said, it is our responsibility as nurses to consistently utilize our inherent assessment skills in the workplace. We should strive to be the patient advocate at all times, even in situations where we are uncomfortable.
It is also important to prevent cutting corners even when busy. For example, we should always use the 5 rights of medication administration. Also ask for help when you need it, especially if the workload has increased to the point that you are concerned for the safety of your patients. A proactive approach is always better than a reactive response, secondary to a patient injury.
If you feel that you have been accused wrongly in a disciplinary scenario, you have the right to appeal the decision. This should be handled in a professional manner, without drama. This will give you the time to do some follow-up work. It will also allow you to present a well-crafted professional defense and tell your story.
Lastly, life is a journey! We are all human and by the very nature of being human we will make less than good decisions at some times. What’s important is that we learn from it, whether it is directly related to your nursing job or to your personal life, and how we grow and move forward.